Publications by authors named "Maria D Fernandez-Garcia"

Article Synopsis
  • In 2023, Europe raised concerns about rising severe neonatal infections due to a new lineage of echovirus 11 (E11), prompting an analysis of E11 cases in Spain from 2019 to 2023.
  • Out of 1,288 samples, 103 were found to be E11-positive, but the detection rates and severity of infections among neonates did not significantly change after the new lineage appeared in June 2022.
  • The findings suggest that the new lineage 1 is not responsible for increased neonatal infections, but the discovery of novel E11 recombinants linked to severe cases highlights the need for better monitoring and surveillance.
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  • Enterovirus D68 (EV-D68) infections can cause severe respiratory issues and acute flaccid myelitis, with a significant rise reported during the fall-winter season of 2021-2022 across Europe.
  • The study by the European Non-Polio Enterovirus Network (ENPEN) analyzed over 10,481 samples from 19 countries, identifying 1,004 as EV-D68, predominantly affecting young children, where 37.9% required hospitalization.
  • Additionally, genetic analyses uncovered two new B3-derived lineages without regional patterns, indicating a notable impact of the infections and the emergence of new virus strains.
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Purpose: Investigation of undiagnosed cases of infectious neurological diseases, especially in the paediatric population, remains a challenge. This study aimed to enhance understanding of viruses in CSF from children with clinically diagnosed meningitis and/or encephalitis (M/ME) of unknown aetiology using shotgun sequencing enhanced by hybrid capture (HCSS).

Methods: A single-centre prospective study was conducted at Sant Joan de Déu University Hospital, Barcelona, involving 40 M/ME episodes of unknown aetiology, recruited from May 2021 to July 2022.

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Article Synopsis
  • Meningoencephalitis in children is often difficult to diagnose, with many cases having an unknown viral cause; viral metagenomics offers a potential solution through advanced sequencing techniques.* -
  • A study involving 47 pediatric patients revealed that 21 had detectable viral nucleic acids using shotgun sequencing, despite previous negative results from standard tests, confirming some with specific PCR tests.* -
  • The findings suggest current diagnostic methods aren't being fully utilized, highlighting the need to consider rare viruses like rotavirus and influenza A that may contribute to meningoencephalitis cases.*
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BackgroundVarious pathogens, including bacteria, fungi, parasites, and viruses can lead to meningitis. Among viruses causing meningitis, Toscana virus (TOSV), a phlebovirus, is transmitted through sandfly bites. TOSV infection may be suspected if patients with enterovirus- and herpesvirus-negative aseptic (non-bacterial) meningitis recall recent insect bites.

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Introduction: In 2021, a type 2 vaccine-derived poliovirus (VDPV2) was isolated from the stool of a patient with acute flaccid paralysis (AFP) admitted to Spain from Senegal. A virological investigation was conducted to characterize and trace the origin of VDPV2.

Methods: We used an unbiased metagenomic approach for the whole-genome sequencing of VDPV2 from the stool (pre-treated with chloroform) and from the poliovirus-positive supernatant.

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Article Synopsis
  • * A rare GI.5[P4] strain was identified, and advanced genome sequencing techniques provided better differentiation of norovirus strains, revealing different transmission chains during the outbreak.
  • * The study emphasizes the need for thorough genetic analysis using whole-genome sequencing in outbreak investigations and the importance of food handlers following hygiene and work exclusion rules when symptomatic.
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On 30 September 2021, the city council of Muxia, Spain (population of 4,564 inhabitants), reported an unusual increase of patients with acute gastroenteritis (AGE). Because geographically widespread villages belonging to the same water supply were affected, a waterborne outbreak was suspected. Overall, 115 probable cases were ascertained during epidemiological investigations carried out by the local health authority (attack rate, 5.

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  • Echovirus 30 (E30) is an enterovirus linked to neurological diseases, with significant interest due to its role in hospitalizations, yet long-term epidemiological studies are limited.* -
  • This research analyzed E30 infections over 26 years by evaluating data from a lab database, where it was found in 173 out of 2402 detected enterovirus infections, primarily linked to neurological issues in patients.* -
  • The study identified two main E30 lineages circulating in Catalonia from 1996 to 2016 (E and F), with lineage F being predominant, and noted that a new lineage (I) became dominant in 2018.*
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The monthly retrospective search for unreported acute flaccid paralysis (AFP) cases conducted as a complementary component of the Spanish AFP surveillance system identified a case of AFP in a child admitted in Spain from Senegal during August 2021. Vaccine-derived poliovirus 2 was identified in the stool in September 2021. We present public health implications and response undertaken within the framework of the National Action Plan for Polio Eradication and the Public Health Emergency of International Concern.

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Article Synopsis
  • New strains of Enterovirus (EV) are emerging through genetic recombination, raising public health concerns in Europe due to their association with neurological issues.
  • In a study conducted in Southern Spain from 2015 to 2018, researchers utilized metagenomic next-generation sequencing (NGS) to analyze cerebrospinal fluid (CSF) from patients with aseptic meningitis and discovered multiple circulating Enterovirus B types, including a new recombinant variant.
  • The findings highlight a genetic turnover with new lineages of EV replacing older ones and stress the importance of genomic surveillance for tracking the evolution and spread of these viruses in relation to human disease.
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Human enteroviruses (EVs) are highly prevalent in sewage and have been associated with human diseases with complications leading to severe neurological syndromes. We have used a recently developed molecular method to investigate the presence of EVs in eight samples collected in 2017-2018 from water streams contaminated by drainage channels in three different locations in Nigeria. A total of 93 human EV strains belonging to 45 different serotypes were identified, far exceeding the number of strains and serotypes found in similar samples in previous studies.

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Article Synopsis
  • - Enterovirus A71 (EV-A71) is a major cause of hand-foot-and-mouth disease (HFMD) and has the potential to cause serious neurological issues, with various genogroups classified based on genetic sequences.
  • - Despite genogroups B and C causing major outbreaks, genogroups E and F are recently identified with limited knowledge about their circulation in Africa, highlighting the need for effective detection methods.
  • - A newly developed real-time RT-PCR assay can accurately detect all genogroups of EV-A71 in biological samples, showing strong sensitivity and reproducibility, and has identified multiple strains in a study of enterovirus samples from Africa.
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Using a metagenomics approach, we have determined the first full-length genome sequence of a human parechovirus type 15 (HPeV15) strain, isolated from a child with acute flaccid paralysis and co-infected with EV-A71. HPeV15 is a rarely reported type. To date, no full-length genome sequence of HPeV15 is available in the GenBank database, where only limited VP1 sequences of this virus are available.

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Background: Enteroviruses are common human pathogens occasionally associated with severe disease, notoriously paralytic poliomyelitis caused by poliovirus. Other enterovirus serotypes such as enterovirus A71 and D68 have been linked to severe neurological syndromes. New enterovirus serotypes continue to emerge, some believed to be derived from nonhuman primates.

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Article Synopsis
  • Researchers studied genome sequences from 8 enterovirus A71 isolates (EV-A71) to investigate their genetic characteristics.
  • Findings confirmed the presence of genogroup C and identified a new genogroup E in West Africa.
  • The analysis revealed significant geographic spread and genetic mixing between EV-A71 and local enteroviruses, which could lead to the development of more harmful strains.
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Enterovirus B69 (EV-B69) is a rarely reported type and till date, only the full-length genome sequence of the prototype strain is available. Besides the prototype strain, only limited VP1 sequences of this virus from Africa and India are available in GenBank. In this study, we analyzed the full-length genome sequence of an EV-B69 strain recovered from a patient with acute flaccid paralysis in Niger.

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During the 2014-2015 outbreak of Ebola virus disease in Guinea, 13 type 2 circulating vaccine-derived polioviruses (cVDPVs) were isolated from 6 polio patients and 7 healthy contacts. To clarify the genetic properties of cVDPVs and their emergence, we combined epidemiologic and virologic data for polio cases in Guinea. Deviation of public health resources to the Ebola outbreak disrupted polio vaccination programs and surveillance activities, which fueled the spread of neurovirulent VDPVs in an area of low vaccination coverage and immunity.

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Besides polioviruses, non-polio enteroviruses (NPEVs) may also be associated with acute flaccid paralysis (AFP). Because poliomyelitis is on the verge of eradication, more attention should be paid to study NPEVs from non-polio AFP cases and their epidemic patterns. In West African countries the epidemiology of NPEVs remains largely unexplored.

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Given the possibility of yellow fever virus reintroduction in epidemiologically receptive geographic areas, the risk of vaccine supply disruption is a serious issue. New strategies to reduce the doses of injected vaccines should be evaluated very carefully in terms of immunogenicity. The plaque reduction test for the determination of neutralizing antibodies (PRNT) is particularly time-consuming and requires the use of a confinement laboratory.

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Article Synopsis
  • Contact tracing for Ebola involves tracking individuals exposed to the virus and monitoring them for 21 days to prevent further transmission.
  • A study analyzed data from 261 EVD cases and 2525 contacts in Kenema, Sierra Leone, revealing an 89% completion rate for monitoring but inadequate registration of contacts, with only 44% of cases having registered contacts.
  • The findings highlight the need for improved contact tracing methods in low-resource settings, emphasizing prioritized tracing based on risk assessment and better integration of case tracking with contact identification.
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